{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T19:31:31Z","timestamp":1791660691223,"version":"4.3.4"},"reference-count":61,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Infect Immun"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Trachoma is the most common infectious cause of blindness and a major public health problem in many developing countries. It is caused by recurrent ocular infection with\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Chlamydia trachomatis<\/jats:named-content>\n            in childhood, with conjunctival scarring seen later in life. The pathogenesis of trachomatous scarring, however, is poorly understood, and this study was carried out to investigate the immunofibrogenic correlates of trachomatous conjunctival scarring. A case-control study of 363 cases with conjunctival scarring and 363 control participants was conducted. Investigations included\n            <jats:italic>in vivo<\/jats:italic>\n            confocal microscopy (IVCM) assessment, quantitative real-time PCR gene expression,\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">C. trachomatis<\/jats:named-content>\n            detection, and nonchlamydial bacterial culture. Trachomatous scarring was found to be strongly associated with a proinflammatory, innate immune response with increased expression of psoriasin, interleukin-1\u03b2, tumor necrosis factor alpha, defensin-\u03b24A, chemokine ligand 5, and serum amyloid A1. There was also differential expression of various modifiers of the extracellular matrix, including metalloproteinases 7, 9, 10, and 12, tissue inhibitor of matrix metalloproteinase 1, and secreted protein acidic cystein-rich-like 1. The expression of many of these genes was also significantly associated with the presence of nonchlamydial bacterial infection. These infections had a marked effect on conjunctival immune processes, including an increased inflammatory infiltrate and edema seen with IVCM. This study supports the possibility that the immunofibrogenic response in scarring trachoma is partly stimulated by nonchlamydial bacterial infection, which is characterized by the expression of innate factors.\n          <\/jats:p>","DOI":"10.1128\/iai.05965-11","type":"journal-article","created":{"date-parts":[[2011,10,29]],"date-time":"2011-10-29T03:05:58Z","timestamp":1319857558000},"page":"121-130","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":35,"title":["Innate Immune Responses and Modified Extracellular Matrix Regulation Characterize Bacterial Infection and Cellular\/Connective Tissue Changes in Scarring Trachoma"],"prefix":"10.1128","volume":"80","author":[{"given":"Victor H.","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom"},{"name":"Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen A.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athumani M.","family":"Ramadhani","sequence":"additional","affiliation":[{"name":"Biotechnology Laboratory, Kilimanjaro Christian Medical Centre, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonda B.","family":"Tolbert","sequence":"additional","affiliation":[{"name":"Biotechnology Laboratory, Kilimanjaro Christian Medical Centre, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Massae","sequence":"additional","affiliation":[{"name":"Kilimanjaro Centre for Community Ophthalmology, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C. 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